This is a proposal to host through partial funding from AHRQ, the 5th International Summit on Indicators for November 4-5, 2002, prior to the 19th International Conference of the International Society for Quality in Health Care (ISQua). With delegates from across the world, the Indicators Summit, is expected to (1) review current issues in use of indicators to measure health care quality and safety (2) review and discuss the gains from the public release of performance data, and (3) review current initiatives in international indicator development and use, examine emerging trends between these and also to comment on the feasibility of implementing international measures of performance. The proceedings from the meeting will be disseminated in several ways including: (1) publication of selected papers as a supplement to the International Journal for Quality in Health Care, (2) access to PowerPoint presentation materials also (3) abstracts available on ISQua's website and online updates on further developments. The Summit has been designed to be a multi-national 'think tank' on emerging issues in clinical indicators for national health policy leaders, senior service providers, clinicians, researchers, and funding organizations. This cross-section provides a unique opportunity for liaison and the development of ideas. Up to this time, only a limited exchange of scientifically-based information has occurred within Europe, yet there is increased emphasis on the portability of suitably qualified health professionals within the region and also equity of access to quality of care for European citizens wherever they find themselves. Learning from the wider world network and cooperation at this level through the Indicators Summit, is expected to significantly raise interest in indicator development and effective use within the region. National and international interest in patient safety indicators, particularly related to medical error, is increasing. Different nations, and groups within nations have varied perspectives on how best to achieve performance improvement including implementation of higher standards of patient safety. The ISQua International Indicator Summit will have the potential to take a significant step forward in determining what may be feasible at the international level.